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Respiratory education and training issues
P90 Simulated bronchoscopy training delivered by experienced peers improves confidence of new trainees
  1. A R C Patel1,
  2. S Mandal2,
  3. J J P Goldring1
  1. 1Academic Unit of Respiratory Medicine, UCL Medical School, London, UK
  2. 2Department of Respiratory Medicine, Colchester University Hospital, Essex, UK

Abstract

Introduction and objectives Simulation training is widely employed by several medical and surgical specialties for inexperienced practitioners to acquire and consolidate practical skills. This approach is not routinely employed in respiratory medicine to train bronchoscopists. Survey data indicates a lack of confidence in performing bronchoscopy among new registrars. This study examined whether a 1-day simulated bronchoscopy course designed and delivered by experienced SpRs could improve this.

Most of the 1-day course was divided in to three stations:

  1. Hands-on use of two simulators (Accutouch, Immersion Corporation, USA), each trainee had at least 45 min of 1:1 tuition.

  2. A slideshow of airway anatomy and pathology followed by MCQs addressing BTS guidelines.

  3. Hands-on flexible bronchoscopy through a static bronchial tree model.

Trainees completed the Bronchoscopy Self-Assessment Tool (http://www.bronchoscopy.org), including an 8-item questionnaire (5-point Likert scale) measuring confidence at the beginning and end of the course. The questionnaire included identification of further training needs (I would like to learn more about: anatomy, abnormalities, technique, equipment, interpretation of findings).

Results 11 trainees (Male:Female, 8:3) attended the course, having performed a median of five bronchoscopies (interquartile range 5–30). Nine trainees had completed <3 months of StR training, two trainees had completed <12 months. Confidence scores were normally distributed, therefore are presented as mean ±standard deviation. Confidence in all eight aspects improved, significantly in 7/8 (see Abstract P90 Table 1). Every trainee reported an overall increase in confidence (median 1.5 points on the 5 point scale, interquartile range 1.1–1.8, p<0.001). Seven attendees identified fewer further training needs at the end of the course. Overall, trainees identified 36% fewer of the five further training choices they were given, indicating that these had been fully met.

Conclusions A training course focusing on hands-on simulation run by experienced registrars for new registrars clearly increases confidence in technical aspects of performing bronchoscopy and interpreting findings. Although a proportion of training needs for most trainees appear to have been met by the course, it is not sufficient to meet them all. Early peer-to-peer simulated bronchoscopy training is a helpful addition to the current ‘on-the-job’ model.

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